HUE030472T2

HUE030472T2 - Interbody cage

Info

Publication number: HUE030472T2
Application number: HUE14736616A
Authority: HU
Inventors: Wolfgang Ries
Original assignee: Joimax Gmbh
Priority date: 2013-08-14
Filing date: 2014-06-25
Publication date: 2017-05-29
Also published as: CN105407839A; ES2618340T3; JP2016527982A; EP2983622B1; JP6685519B2; DE202014003441U1; CN105407839B; KR102282533B1; US20160193055A1; WO2015022039A1; US10226357B2; EP2983622A1; KR20160042821A

Description

The pffppt IwiÄto'pertains lo an unerbody cage. intervertebral cages arc called interbody cages in b ug I i s h. Re t n to rc e id era es the spew between tA ox o xervbrat i-xdev >J!e> too ίγχ the levon ss pwfo' m* g m e nmnlx r et spinal ¢- *mns especially lesions to iniemurebrsl disks, such·ást Sopudvlohsihest? and inst&mhtx rolloxviug disk hemiauoo, due to stenosis ami degeneration. Follow ing remoxai of an oueivetmho!.. disk., which is atVeeted by the lesion and/or causes «nervet damage, Ironvthe intersenehui disk x'k\ ^ftxS'.\ tx'· > ' eik^'je o *. o m v| ^ a ok ' e d u^ox > ^ 'χΐ % ,fv x'vtho* s xets a e t s. ted v s u to 'c π,ι K x ik s.\ < 'lepi o » b spec \ reinforced at least in the area of these two xenebrae This is called., e g . lumbar interbody fusion ILII'T The vertebra are optionally also presided, in a minimally I massive spinal procedure,, with a sorexvood unit, facet tobt screws or transl&minar screws and braced against the cage located between them. U is thus also desnaPle lor the boÄ^eÄ.feMiwiÄ#'#''^ii--5·· buch α enge X» thoif f.ve nacOix movided with a rough surface.

The basic object of the pcsetldnvcotlon Is # proyf# an interbody^ oage,;yvMbb posMssp improved propertm

Provisions arc made In a preferred embed imént, for a Ifatue del ermittmg: lie outer contour ansi a ;lÄfn said iVame prepared, in particular, by sintering, such as by means ofelerirau beard milting; or laser sintering. w*ih a cage ihat has at least areas xvith a iatüeedtkeor grid-bke stroeum It is ootvespondingty fbroted with bbieedike or gnd-hke areas. ^lit^Ä^ii:preferably produced by sintering, especially by means of (selective) eieemtn hmm mekmg ublM^MTot bx means of I.*,no; \uuetmg tt SU Ac .vtdntglx, the mge sS produced by sintering, e g . bv means of ekwon beam melt-ng or laser sunering jgrâMike are-ittpreferably exroud Dom an upper sunhce or lateral surtaee to hepndb' oxw" s ' ^ mer' Mîi^Xv *<x % xd t '"w V * ΝνΚηκ'Ο n » x 'nVax Äi po% on the.«^Äi^»i?r«aI!y on the surfacCx but n will also grow mto the mvtiiës of tie grlil-like irilaiilÄllbiXgnctur« and thus can fully penetrate the cage and bong growth wilbbepromoted. A irp ggnneetion is achieved hereby between the cage and the adjacepti vwehrai body

The cages may preferably have a length of 22 rom to 40 rom and a width on the order rtf magnitude of between I Orom and 15 rom and a dUTere»i;Mp|:.^ngiigjfcm 6 mro to Id rom depending on the patient's constitution and the site of insertion ami the vertebral bodies and the intervertebral space thereof into wh|thThe eáge Égll be Inserted With these widths and hetghts, the cages e to ne owe'ted roto the nne*xe*tehrof space between the x ertebt.xl bodies through a working slgtw e

Fort heron the cage is provided with art outer dame, which comprises massive carry mg parts, and with an inner grid body. Due to the cage being designed with two structural element, mono - es tt\" da..Os. eo «engx ' eonrowu mate* ' mi! nur (wo'nft0 4 uu n are ,m snou grid bods with aatd lantétdtkx. or gnd-hhe onnone ondoom length and rigldltf is litpprtid to the cage; vMilt ihkt#eoropeti infiltration of bone material through the cage and the grid4ike ^ructtir^Í5er0ffp.f«i^v^k M'^e x" et f X gs d nem χ v.«v*' \wted t tό f s v rop» dxC u! eex < χ . v! χ. m o*o daeetiun. narneX in tratwverse direction, only, h»u w not connected to the frame on sut X es and odges: egÄdlttg ; to those tor tuer aorta ces An -uncoupling of the outer frame and the grid body of the cage is achieved hereby in a certain way by the two bcthgincdöpled teäilli^tuiinälJiÄÄ^'ÄeÄÄäÄHba'fc'Wiiioh the cage extends phi cage ta -longer a«d in its height)

When the trame yields, tor example, in the area of ribs forming it under pressure being exerted on it, this pressure is not transmitted to the grid body. :u«e*«npr*xotjvx' ^mf at*'" v -u > χ * crown mien ímíol ^ reim w<' u dantxtmxi íFí'dvIaiphSíare made ii«a proibWh varitól .for the upper and lower '» r xK N't tCx* roe* «tu' s Xv ηθΝχ* η ' χ u ». i fed w t' me»»'·' vevuKx\>e surround said sur Cages oi the grid body.

Pro\ mans are made mahofhergmbplineet of the cage öc#^bg»tí« presoni invention fsr **'' *>ao\' to amiomse e e.nns so\vh«yh 'he * *«J b xk '* a *m \*d komámé-, ax- mack m a xmarsî fos dv **asm to have h-ngttudm<si nks s \tonmng m η» kmgsiudsoal dncv.hm Jhovsssona w% Ü8Ä IftÄÄremely preferred ex^íKlkeeaf ibr adiaeeiss longitudinal obtto fee connected in the confer by gross ribs. Ifeg-stability of the frame and 1mm of fheoage itself Is itnereafe#^^ of longer cage*, lie lattice of grid structure of the grid body of the cage may have various designs Provisions are made in m extremely preferred embodiment for the grid area or grid body to he h diamond structure.

Provisions may be made m another embodiment of the cage fur the cage having a continuous passage The passage extends in the the fiamé and especially also through the god hods -m* If It w a Urn \cd hesek dun the % aae can bo msekesi h\ me ox of an insertion instrument through a tubular lock or an endoscope tube via a guide wire extending into tlie lhterverta&mi disk space. further preferred emboÉtUerif of the cage according to t ho p^ÿinpp^pw character feed in that the grid-like areas or the grid hodv have grid opening diameters of each opening ranging from 0 5 mm to 3 5 mm, the opening diameters of each opening being on the order of magnitude of 0 5 mm to 0 ? mm preferably on the outer side of the cage and/or the grid-tike areas or the god hodv its the interior of the cage having openings or perfos amans wuh diameters of 0 ? mm to 3.5 met. especially through a proximal eospeption area for connecting: the cage to an mserlkm instrument

Hn was merilpned, a dap can be produced, especially by (selective) elect?ott beam melting ((5)1¾¾ pr laaef sintering technique (LSI). from a titanium ai!oy< especially IÍ0A14V according to 110 5S32 -3. The eomponehf - cap -· is ptx>dtmed by meitmg meteî powder by miihs of an electron Pant os laser beam under high vacuum Undercuts cat? he produced herehv without lost forms or cores The metal poxvde? tarn be melled in a specific map# by an electron beam or laser beaus as the energy source. ;o a result of winch compact CdhipMÄ of hiMly any desired geometry eati bp ftkpfed directly based on design data A. powder layer isatenatmgly applied by means Of a blade to thdptPviuusly^applied layer and; exposed to tiü fctonIä is generated in tins way layer by layer

Further advantageptod Ibçtgres of the present invention appear tVom the claims ansi kom the following descriptk^yi'Äefe gxeoipiary tbvendon are explained in detail with reference to the drawings In the drawings,

Provisions are made isi a preferred eutheCoiieni fw a prexumd end '.ace u> base a teetii Ï he wobt ow\ aem be pieaem as one uv>th oi more dm si (.me tooth t hr4 me* ot dis' design el the modi may be coordinated with tile insertion instrument Different angular säieotadiism ire made possible heiehv between tíieüp PÉ fciisert» i|gm^#ind'Ii|eoo»p^» to optini.dlv position the vage

Figure 1 show$ a side stew of two vertebrae with interbody cape inserted between diem; Figure 2 shows » perspective top view of a vprfebm with a cage seated on same;

Figaro 3 shows a first embodiment of a cage according to die present invention in a perspective view;

Figure 4 shows the cage according to Figure .3 III longitudinal section, llgpre 5 shows the frame fIpfes 3 and 4 ip aferppective view, I n me *> .4 own v „ ,e r \1\ el* u <. ms accoie îk to n uscn t a'd 4 " a pempeetwe view. figure 7 shows a longitudinal section through another embodiment of the cage according, re Iheifresern invention; üBguto I show - a getfpepive view of tile outer tftë Oil tldogp according; todle pfespt m\ enuon according to Figure 7;

Figm e o nIuwvn a top \ ieo of the cage «ucnidnig to the present tmcmäcr« a cord mg to Figures 7 and S;

Figure 10 shows a perspective view of the grid body of the

Figure 11 shows a cage according to die present invendon with ap Ihaprtldil Insttopiénl; end l gum 1. ehovN\ac-«wih,(ge,i we", efohe ugc et '*k dwta .eta of the according to Figure 1I. '^ÄÄ#:lÄÄf#Tät disk is to be removed from the intervertebral space 2 between two nw c“( in \ t ot a .-, nee ' v ιΟ w.tohf«t ,w loc n J ow -iN>w 'K'o*hti Kvaiwooi îomou loan intervertebral disk in die spine of a patient, a cage is inserted instead, in order Us lamp thevertebrae at a. suitable distance, as this is shown in Figures I and 2. This is, as a rule,

accompanied by a reinforcement oft lie spina in Ous area. so that xht two \ enebia© 3, 4, t'Mssfipmwhich the cage 5 is inserted, arc m longer m*w able in relation to one another Bracing mav additionally be performed bv mesne of a M rtmnslaminarscrews hurthetmore. it h deaivabb i>r ibi cage 5 to ins© with ÄÄ^rai mâ. It is designedaceordinghx

The be inserted Id different directions to the· processus spinosl 2.i. :u, ns an e-Hiqtna ace {O-cape) whh fût angular orientation -4'abom y·''' to the pou os.ms giinosl iu me esompiaryembodimentbdtng shown. Posterior cages (Pacages) are shonet than O-cages and lute a lengthoÎ24 tits to oíflnng depending en the panent: They are inserted into the intervertebral spaeedorsally next to the processes spinosus slightly obliquely in relation to it.

Hie height of the cage 5 most be adapted to the - ongm.d - height ot the intervertébral ; space . eliioh may differ from person to person Therefore, cages 5 with different heights are to be provided depending on the patient's constitution, f uture 0 shows a cage with a height oft m o and I igtm - tuoig ^ Joä « age wee . bond a >1 * wm s ages with mm increments a ten s·, rail y p.r os I d ed

In the figures showing the preierred ertflteeg,^ on ennem comprises ht principe two mam eomooncuts namely an - miter - massive dame and an · inner grid bod}· 7 Tim god tvdv ” has a grtd structure, ps eterablv a diamond; grid stuKiutewith thin ribs 7 I and wdb free intermediate spades between these, the âhmMWMÆ the ribs 7 I ,espéipiillyi|hg:-:ihiv hre^a tluoef to- a direetio,» at right angles to the uhecimn in which the ríbsextend between two nodal points, at which they are each connected to additional ribs of the gtidjheiug small compared to all dimension;?· ofstructural components of the frame 6, for example, a width of ribs of the frame 6. I he six© ratios art at least 1 to 10. 'Hus correspondingly alsoapplies to the length of stmts 7.1 of the grid body 7 between tw o nodal points and to longnudn uiomensm,"· of míU-IUk:' part,- -.a the frame *\ such ,--s ?.ud nbs, so that the ratio is at least I to 1 Obere as well IIHr cage 5 is nevertheless a one-piece cage even if it comprises two main components, the dame e md tbs' arid bod\ “ 5 sie as\ N h kvge V T* ' îi's ' ' '.vss v *. e ' \\ ' vî!o\' w ' ' e '% vgu ' H' <1 v-so- m d τνοηνν,ν kco o ' ,u\t es te !o se a eaxus >'· a ,ph thv m w v H foc gosl Iv-k o k'> ,*100.0 no tvvheu , ,sge Vhc 'foi b .ne eoeueesed K' osv umnhe* h\ oson π On o ^ os îhe centet i^^ain-bbut hilf éffis# lángiti, tho ébi®ésfol disheih| alwaysdbs h relpaBtsvafyJr paisageSfo wii aoiofiingly reesfss between ire eyps rihs 6.5. OotTeapüpdldg passages é.2.1 and 6.31 arealso located m the distal end area 6.2 end is lhe proximal etomechots area 6.3 Moreover, thegsid body ? is also probidld wih alongindií^al passage ?. 2, plie h is flush with theafcwrememioncd passages. hï an extremely preferred embodiment. îht gnd hsxiv 3 and the 6orne 6 are connected so oste msofoe? ss^ or-e meet- « esfo sn s.vus foce: osv-, extending at ogle angles so·The lostgscs.lfo tl * \C' * * i I * et\* , ; -js *!x u \ u I *v ., fa,\ 1 i u\ i t\v a , v s* tef t b vofhthe Mirlaces 7 3, ? 4, :- \ 7 ? \ Hgts*es e a soi U*î

Ik wY- nvo. χο^ <. οχ vd xssV s ' 6 NnJ aiv > yr * d *.#>> xt., 1 n ~-N ,d ον grsdbodx ore saxtrstodb, , we voted so she f.ssne - In ^ddittor oapeeialh the dtnsenatotxs ol sheupper surfaces ? 10 and of the lower surfaces which are incsted opposite and in parallel to iflpaposi the ussderside of the grid bodies 7, eotfppotfo to ilereeesses !l$|#«giui(iissal rsbs 6 I ; tle erpss 6bs6.5 &nd|he trié fapesifeas 6,2 4f Wti-ÄÄt'iÄlÄ cphieeiUm arm 6 3. Tins eMieafhpxvIvnpTilsttmload action the lorigitudfsaliiis&i through foe ypriihtnl bodies 1, 3, lim load the longttudiiiW^i^iasip'il# grid body 7 and It thus remains smdeförínéd ÍM eaiassomeáts fa|| pfgparapteeipg the shiegration of bone material istto foeathpstap^ of the grid bodv e es en nodes shew eneusxt'uasves Πν conmmouriongitndnxai passage of ne cage c makes tt possible for the cage to be able to be inserted mt.o the intervertebral space via an indcv-eilh-sg guide wire.

In the embodiment off cage 5 according to tint present invesstiou according to figures 7 tlrotfgh 10, the proximal connection area 6.3 of said cage has (a? the fsamé 6) teeth 6 3.1 on snpttTxrmallv dtvacted oute* eskl ftce o ' > I Hese asc * \ed *o mîvUîc a p eve*. amm a orienfatto^b'ett^e'n^n insertion instrument 6 and the cage 5 during the fsxahon ol the cage 5 alt he distal end of the insert son ims-aostserst H (figure 1.2) b> <m axial bracsssg between a hamsoerdskefoeksng member of the ssssertson instrument a# ^ thereof Ihe îedth lobowing each other *8 o m N nf* \m o "' h'i ,\hh s 00of dm '.o-mocd pwvnmo : ' o"'the*4«e

The design $e g , number, distance, shape) of the teeth 6,8 4 msv he coordinated vslrh the mm." do t uiaticmem y ..eel οι me meshing Vins nukes po-smm m> ox one Hand, vpom u compatibility with the insertion instrument 8 and increased stability oi the connection hetoewnho ebutnvet s > m'she mo,·: hon nuwomew 8 ,mo do museum connection anw 0 ' O' the cage 5 and on the ethei hand, a os eat cartels ofconnectkm angles.

The insertion of a cage 5 accord mg to the present invention is earned out by means of an insertion instrument 8, as this is shown nt Figures i I and 12 A locking element formes! by ary outer tube 8 1 hasa hammer-like locking part rotatable about ns longitudinal asm (non her of them being shown), which said locking gart i& insetted in a venu.at orientation into the passaged i.i of tire proximal connection area 6.3 of the cage 5. for example, m the view· of the cage eshovsn in twines ' fw-ugh 5 On ns p'UxhnA end face, bv * aye s hae aeno-kuut occ' ^ főt 0's 'd'os o|\m \. ofo$s ssvtn" s niovumds to fm 1 A 'K e ouent o*· thetttsertion instalment 8f the undercut opening forms a locking element on the enge 1 which makesil possède to lock the insertion

The hammer-like locking part of the insertion imstn.tment is then pivoted by Af' relative its the outer ttthe 8. L so that it will mesh, with undercuts ή 8.2 on the inner side of the wall offne proximal connection area 6 '3 The hammer-like locking part and concavely bem front edges H 2iu e braced against one another by means of clamping devices at the proximal end of the, msettionmsirumem 8 m an abutment 8 3 provided distaliy at the outer tube 8 1 via the interconnection of thepro.ximal connection area 6.3 of the cage $, wherein the locking part extends behind s&kl proximal connection area 6 3 of the cage 5 Thu cage 5 is held firmly at 'o n-wO^'i oi'-m-ivcm Kochs I b \ makes "uvsvble fu the caw " to move m tK diw turn in Auch H extends and with a component tnremtion to the direction in which the insertion instrument 8 extends. IT the proximal connect ionarea 6.3 of the cage 5 has a teeth 0.3.4 on its rontó)unó i x e ο N I fis ivwnfo tó > v. i t omuo b aw. »the« * t instrument 8 .md the cage 5 Nevertheless pivotingbetween the insertion io$mmvenr8 and the cage à m the pcrpendseular direction to the longitudinaievtension !, of both about a considerable angleosl up to 30s and more is possible, as is shownespeeialpy in the view: oflbe design ol the reetes txi 2 having a circular shape according loFigure 4.

Claims

ÖilOOLf M.ÖEI Basket SEA1ADA |, WHAT'S POINTS: I, Intervertebral Cart, which is a solid frame (6.L 6.2, 6.3, 6.5) standing frame (6) Also an inner part, «zzal jhogy â reestest (7) only I can handle it, especially harantiranaysl parallel surfaces (: 7.3, 7.4, 7.5, 7.6) Connected to the frame (6), but with these surfaces (7.3, 7.4, 7.5.7.6) finely angled feiiletelóiéi (7ΑΊ and safes «7.91 not connected to the frame (6).

2. According to claim 1. basket, characterized in that a frame defining an outer contour and a mesh grid portion within / within this frame are clustered as vgs.

3. The; a basket according to any one of the preceding claims; characterized by sintering, e.g., laser color rendering).

Basket according to one of the claims 13, characterized in that the electron beam is predominantly selective in the form of a fastening belt: vtn:, live. $. Basket according to one of Claims 1 to 4, characterized in that the upper and lower surfaces (7.10) of the grid body (7) have the same "stems as the square spaces surrounded by the frame elements (6.1, 4¾ 'iJg 6 * 5). that surround the surfaces (7.10) of said body (7). A basket according to one of claims 1 to 6, characterized in that the frame (6) engages a hollow space in which the Master (7) is positioned.

7. Basket according to one of the claims 1 to 4, characterized in that the frame (4) has a length of #: ios $ glxtrdát ^ .. p..l) and is mainly connected to each other on the transverse ribs (6). , 5), I * The basket according to one of the previous Claims, with a violation of the fact that the death of the tree or the body (6) is vgn, #, The: the previous one is a basket of four, with Jífernezpe, that vegigmono is an arsenal! (7.2, éM.

Basket according to one of the preceding claims, characterized in that the grid-shaped parts or the ridge (?) Are all. »» 5 »» # 3 * 7 mm k ^ Mti ssn ^ iâsÃ Ã â‚ériâ „él éri 2 2 2 2 2„ „„ „„ „„ d d d d d d d d s s s s s dal dal dal dal dal dal dal dal dal dal dal dal dal dal lás

11. A basket according to one of the preceding Claims, mmI, characterized in that the grid shape (?) Inside the coat is between 0.5 mm and 3.2 mm between the api of the api or the breakthrough apertures.

A basket according to any one of the preceding claims, characterized by a eg> proxitial linker fox {63 k which fits into the basket> insert / osm / anmnv socket "s: opl eS: mostly oz (ir) pocket, basket (0 | the plilillaines have "inner side" sleeves (6,3.2), which enable the joining of the joints in the angles of the shoulder (8);

13. A basket according to one of the pendulum pegs, characterized by the fact that a pivot part {.63) has a cutout on the upper side of the basket (5), which is the basket (S) and the pivoting bracket (allows sliding angular movement.

14. One of the previous Points of Interest is a basket, with a ppoKimails firewall (6.3.3), with fuzz (63.4): elongated, and hollows (6.3, 4) jet | they are hollow in succession, and the bows (6.3.4) are proximah on the forehead. cross (6.3,1) on both sides e! are placed.